Eyelid Surgery Is a Consistently Popular Treatment

If your upper lids are baggy or droopy, an eye lift can provide a more alert, energetic look.

Bags under the Eyes

A lower blepharoplasty can have a dramatic effect on the appearance of under-eye bags.

Poor Vision

With an upper blepharoplasty, Dr. Justo can target the excess skin interfering with your peripheral vision.

Wrinkles and Lines

Eyelid surgery can also improve the appearance of visible signs of aging, such as wrinkles and lines around the eyes.

We Use Advanced Techniques to Address a Range of Concerns

At Arizona Eye Institute & Cosmetic Laser Center, we offer a variety of types of eyelid surgery. Dr. Justo can tailor your blepharoplasty to your unique needs and concerns. One of the most common reasons patient seek an eyelid lift is due to sagging eyelids.

In some cases, this issue is caused muscle weakness, a condition known as "true blepharoptosis." However, more often, patients suffer from "pseudo-blepharoptosis" due to excess skin and fatty tissue. Whatever the reason for your concerns, Dr. Justo can perform advanced, minimally invasive blepharoplasty to improve your vision and appearance.

So how do you know if surgery is right for you?

Good Overall Health

As with any surgery, patients should be free of health concerns which could lead to complications.

No Tobacco Use

Since nicotine can interfere with healing, we strongly recommend quitting at least several months before surgery.

Realistic Expectations

While an eye lift can provide a significantly more youthful appearance, it cannot completely reverse aging.

Eyelid Surgery Techniques

Dr. Emilio M. Justo of the Arizona Eye Institute in Phoenix, AZ, explains the benefits of laser blepharoplasty, or laser eyelid surgery. He discusses why the procedure is performed, what patients can expect during surgery, and how their lives will benefit in different ways, from upper and lower eyelid procedures. Many patients don’t realize that the upper eyelid procedure is often covered by insurance. Laser therapy offers several advantages over traditional blepharoplasty.

Laser Eyelid Surgery

We are proud to offer laser eyelid surgery, an advancement on traditional eyelid surgery. This state-of-the-art procedure involves the use of a carbon dioxide (CO2) laser to remove excess skin and fatty tissue.

After making small incisions (sometimes on the inside of the eyelid, other times within the natural crease to camouflage them), the UltraPulse Encore laser instantly and precisely ablates tissue around the upper and lower eyelids. The laser beam tightens loose, sagging skin, and eliminates bags beneath the eyes. Since the laser beam cauterizes the blood vessel as it reshapes the tissue, it prevents bleeding during the procedure and allows Dr. Justo to visualize exactly how much tissue to remove. This makes the procedure quicker, safer, and more effective than traditional surgery.

Benefits of Laser Eyelid Surgery

The benefits of laser eyelid surgery include:

No incisions with scalpels or knives

Provides the ability for greater precision

Greater access to small and delicate areas

Reduced chance of post-operative swelling

Quicker recovery than the traditional procedure

Less risk than with traditional eyelid surgery

Quicker and more effective when compared to traditional eyelid surgery

Simultaneous laser skin resurfacing for the treatment of lines, wrinkles, and crow's feet around the eyes

Laser Eyelid Surgery

Dr. Emilio Justo of the Arizona Eye Institute in Phoenix, AZ, explains laser blepharoplasty, or laser eyelid surgery. He discusses why the procedure is performed, what patients can expect during surgery, and the difference between upper and lower eyelid procedures. Laser therapy offers several advantages over traditional blepharoplasty.

Watch a Live Eyelid Surgery

Upper and Lower Eyelid Surgery (Blepharoplasty)

Dr. Emilio M. Justo invites you into his surgery center to witness as he performs an Upper and Lower Eyelid using the CO2 laser. A four lid blepharoplasty eliminates the excess droopy skin on the upper eyelid (a process often authorized by insurance companies), as well as eliminating bags under the eyes. Watch as Dr. Justo explains the procedure and shows each step. Portions of real surgery are included in this video.

Insurance Coverage

Like many patients, you may want to correct your drooping eyelids to improve your vision. However, you may be worried that you will not be able to afford the treatment. Fortunately, functional upper eyelid surgery is often covered by insurance. We will take extra steps to help you obtain the coverage you deserve.

Before beginning treatment, Dr. Justo will conduct a visual field test to determine if your drooping lids have significantly impaired your eyesight. If he establishes that blepharoptosis is affecting your vision and quality of life, he will submit your test results and photos to your insurance company to obtain treatment authorization.

Muscle Tightening Eyelid Surgery

For individuals whose upper eyelids have slowly drifted down to cover part or most of the pupil, common factors include the aging process, muscle weakness of the elevating muscle of the upper eyelid, or in some cases, familial or genetic predisposition. An eyelid droop caused by muscle weakness is known as “true blepharoptosis.” More commonly, drooping eyelids are caused by the overhang of excess upper eyelid skin and fatty tissue, which is known as “pseudo-blepharoptosis.”

If we determine that muscle weakness is causing your droopy eyelids, two separate procedures can be utilized to correct this issue:

Benefits of Muscle Tightening Eyelid Surgery

Tighter, firmer skin can make you look years younger, not to mention healthier and refreshed. Sagging eyelids can make you appear old, unhealthy, fatigued, and even depressed. All of these traits can have an impact on a person's demeanor and self-esteem. By performing eyelid surgery, we can not only improve your appearance, we can improve your self-confidence as well.

The Difference Between a Muellerectomy and a Levator Surgery

Arizona Eye Institute & Cosmetic Laser Center's Founder and Medical Director Emilio M. Justo, M.D., invites you into his office to learn the difference between two eyelid tightening surgeries that relieve patients from limited vision and a tired appearance.

Muellerectomy Procedure

Dr. Justo performs the large majority of his upper eyelid “muscle tightening” procedures using a procedure known as conjunctival-muellerectomy surgery. This 15-minute outpatient procedure is performed under local anesthesia with minimal discomfort. The procedure involves a small, hidden incision underneath the upper eyelid, followed by placement of an absorbable suture that dissolves in approximately 10 days.

The primary advantages of such a procedure are:

Short operation time

Minimal post-operative bruising and swelling

High degree of accuracy, reproducibility, and symmetry

Avoidance of post-operative “notching” of the upper eyelid

Avoidance of any skin incision or scar

The main disadvantages of a muellerectomy are:

Limited degree of elevation of the eyelid in cases of severe eyelid droop (blepharoptosis)

Does not correct any skin sagging that may co-exist with the muscle weakness

During your initial consultation, Dr. Justo will discuss your options in detail and help you decide on your best course of action.

Tighter, firmer skin can make you look years younger, not to mention healthier and refreshed. Sagging eyelids can make you appear old, unhealthy, fatigued, and even depressed. All of these traits can have an impact on a person's demeanor and self-esteem. By performing eyelid surgery, we can not only improve your appearance, we can improve your self-confidence as well.

Muellerectomy (Eyelid Tightening Surgery)

Watch as Dr. Emilio M. Justo demonstrates on a live patient the Muellerectomy surgery, which tightens the patient's eyelids to dramatically improve their vision and appearance. This video contains clips of an actual surgery.

Levator Resection

If you show signs of marked muscle weakness with the eyelid clearly falling below the level of the pupil, or you require a secondary (repeat) muscle-tightening procedure, Dr. Justo will recommend a traditional levator aponeurosis advancement and tightening procedure. This procedure is also performed using local anesthesia although it is more time-intensive and requires a skin incision through the upper eyelid crease. The main advantages to the levator resection procedure are:

Can elevate the upper eyelid to a much higher degree than with a muellerectomy procedure

An upper eyelid blepharoplasty (removal of skin and fat) can be performed simultaneously using the same external skin incision through the upper eyelid crease

The primary disadvantages of the external levator resection approach are:

Requires longer surgical time, approximately 20-40 minutes per eyelid

Typically results in greater post-operative bruising and swelling than the muellerectomy procedure

Small risk of “lid notching” of the upper eyelid which can sometimes result in a slightly less than natural lid contour

Levator Repair Surgery

At times, a patient may require a procedure called Levator Repair to tighten their eyelid muscle successfully. In this video, our Founder & Medical Director Emilio M. Justo, M.D., explains the procedure and showcases his work on a real patient. This video contains real video of surgery. Another option that Dr. Justo uses to repair ptosis and tighten the eyelid muscle to improve vision and appearance.

Dr. Justo has performed hundreds of muscle-tightening eyelid surgeries since 1989. He states that “an eyelid lift is really a misnomer as most of the public views an 'eyelid lift' as the same term as a blepharoplasty for removing excess baggy skin and fat. However, performing a blepharoplasty does NOT truly elevate the position of the upper eyelid. The only real way of 'lifting' the eyelid is to tighten the muscle(s) of the upper lid so as to elevate lid position away from the pupil. Hence, in reality the true 'eyelid lift' is really a muscle-tightening procedure.”

Lower Eyelid Surgery

Outpatient Lower Eyelid Surgery removes excess bagginess under your eyes for comfort, quality of life and improved appearance. This patient had upper and lower eyelid surgery.

Lower Eyelid Surgery

Do your lower eyelids appear baggy or puffy? Do you look tired all of the time, or even swollen? Or, do you have loose, wrinkled skin below your eye? Lower eyelid bagginess can cause a lot of stress that can impact your life in a big way. Baggy lower eyelids can influence how you feel, both physically and mentally, and how others see you.

Fortunately, there is a relatively simple outpatient procedure that can eliminate lower eyelid bags and improve texture of your eyelid skin, resulting in a smoother, more youthful appearance that will improve your comfort and quality of life.

You don't have to live with bags under your eyes any longer when you undergo lower eyelid surgery (aka lower lid blepharoplasty) at our Phoenix area practice. Arizona Eye Institute & Cosmetic Laser Center's Founder & Medical Director, Emilio M. Justo, M.D., was one of the first surgeons in Arizona to perform the lower eyelid surgery using the state-of-the-art Ultra Pulse Carbon Dioxide (CO2) Laser for better results and improved healing. Dr. Justo performs the procedure in his Medicare-certified and Arizona state-accredited outpatient Surgical Center located conveniently in our Sun City West medical office building.

Much like upper eyelid surgery, Dr. Justo will sit down with you for a detailed consultation to determine whether you are a candidate, and to customize your surgical plan for your individual needs, to ensure the most desired and natural results. Dr. Justo will ensure that your every question is answered during your consultation.

Trans-Conjunctival (Internal) Incision Lower Eyelid Blepharoplasty

For Dr. Emilio Justo, approximately nine out of ten of his lower eyelid blepharoplasty procedures are performed using this trans-conjunctival or internal technique. With the patient having IV sedation such that he/she is under a deep twilight anesthesia, Dr. Justo uses the Ultrapulse CO2 Laser to make a small incision on the inside of the lower eyelid thru the conjunctiva, which is a mucous membrane tissue. Dr. Justo then teases out and removes the protruding fat pockets causing the external puffy appearance. This internal incision does not require any sutures as it heals very quickly in a matter of days. In general this technique results in minimal bruising and swelling. In the vast majority of such cases using the internal incision, Dr. Justo will at the same time use the Ultrapulse CO2 Laser to perform a “laser peel” or laser resurfacing technique over the skin surrounding the eyes (peri-ocular) to help provide gentle tightening of the skin and to texturize any fine lines or wrinkles. The patient is discharged home the same day after this 30-minute procedure.

Sub-Ciliary (External) Incision Lower Eyelid Blepharoplasty

In a much smaller percentage of his lower eyelid blepharoplasties, Dr. Justo will use an external incision beneath the lash line extending from the inner corner of the eyelid and ending just beyond the outer corner of the eyelid. Using this technique, Dr. Justo will excise and remove a thin strip of skin from the lower eyelids for those patients in whom he feels that the internal incision technique in combination with the laser peel may not be sufficient to create the desired appearance. However, with the external incision technique the procedure takes at least twice as long and the patient is subject to more bruising and swelling compared to the internal incision technique. Also, Dr. Justo does not perform a laser peel of the “peri-ocular” skin at the same time the external incision is performed so as to avoid creating skin which is too tight and not natural looking. This external incision technique is very beneficial for those patients who clearly demonstrate a significant amount of baggy or loose skin in his/her lower eyelids.

Benefits of Lower Eyelid Surgery

Diminish or eliminate baggy fat pockets underneath the eye resulting in a more youthful and "less tired" appearance.

Reduce any excess skin or tissue that is creating baggy lids or skin.

Can smoothen and texturize fine lines and wrinkles both beneath the eyes and around the “crow’s feet” area.

Upper and Lower Eyelids

While you may only have lower eyelids that are troubling you, it is not uncommon for the upper eyelids to be impacted by droopy skin or excess tissue at the same time. During your consultation, Dr. Justo will review both upper and lower eyelids. If you are a candidate for blepharoplasty on both your upper and lower eyelids, Dr. Justo will review with you the option of having both procedures completed during a single surgery. It is recommended that you schedule a consultation with Dr. Justo to confirm your candidacy for upper and/or lower eyelid surgery, as well as review corrective options that fit your needs.

Upper Eyelid Surgery and Insurance

If Dr. Justo diagnoses your upper eyelids as requiring blepharoplasty, then he and his staff will work closely with your insurance provider to seek authorization of the upper eyelid surgery to be covered through your benefits plan, if applicable. Upper eyelid surgery is often authorized by insurance providers as medically necessary due to the impact of droopy eyelids restricting your peripheral vision as well as leading to eye fatigue and brow strain.

Global Fee

Because we operate our fully accredited surgery center right here on site, you can always count on the Arizona Eye Institute & Cosmetic Laser Center to quote you one global fee for any cosmetic procedure not covered by insurance, with no surprises or additional fees. Any cosmetic procedures provided by Dr. Justo have one single global fee which includes the professional surgery fee, the facility fee (operating room, nurses, surgical supplies) and the anesthesia fee all bundled together so as to minimize any confusion for the patient.

Watch a Lower Eyelid Surgery

Dr. Emilio M. Justo performs a lower eyelid surgery to eliminate baggy eyes that make the patient feel and look older and tired. Watch as Dr. Justo explains each step of the procedure. This video contains actual surgery on a patient.